title: Atrioventricular septal defects: lessons learned about patterns of practice and outcomes from the congenital heart surgery database of the society of thoracic surgeons.
abstract: During the 4-year time interval of 2005 through 2008, the Society of Thoracic Surgeons Congenital Heart Surgery Database documented data about 2882 operations to repair atrioventricular (AV) canal defects: partial, 623 (21.5%); intermediate, 342 (11.8%);. complete, 1917 (66.3%). Mean age at complete repair (years) was as follows: partial, 6.1; intermediate, 2.9; complete, 0.6. Median age at complete repair (years) was as follows: partial, 2.6; intermediate, 0.9; complete, 0.4. Down syndrome was present in 1767 patients (61.1%). Debanding of the pulmonary artery was rarely performed: partial, 1 (0.2%); intermediate, 0 (0.0%); complete, 66 (3.4%). Deep hypothermic circulatory arrest was rarely used: partial, 6 (1.0%); intermediate, 5 (1.5%); complete, 52 (2.7%). Discharge mortality was low: partial, 2 (0.3%); intermediate, 3 (0.9%); complete, 38 (2.0%). Atrioventricular block requiring permanent pacemaker occurred but was uncommon: partial, 6 (1.0%); intermediate, 2 (0.6%); complete, 29 (1.5%). Unplanned reoperation prior to hospital discharge occurred in 3.9% of complete AV canal repairs. The sternum was left open in 3.0% of complete AV canal repairs. Postoperative cardiac arrest occurred in 1.9% of complete AV canal repairs. Mean postoperative length of stay (days) was as follows: partial, 5.2; intermediate, 7; complete, 13.1. Median postoperative length of stay (days) was as follows: partial, 4; intermediate, 4; complete, 7. This review of data from the Society of Thoracic Surgeons Congenital Heart Surgery Database allows for unique documentation of patterns of practice and outcomes. From this review, we learned that 98% to 99% of patients survive complete repair of AV canal and 96% to 97% survive complete repair of AV canal with no major complications.
authors.affiliation: Congenital Heart Institute of Florida, All Children's Hospital and Children's Hospital of Tampa, University of South Florida College of Medicine, Cardiac Surgical Associates of Florida, Saint Petersburg and Tampa, FL, USA.
authors.forename: Jeffrey Phillip
authors.initials: JP
authors.lastname: Jacobs
authors.forename: Marshall Lewis
authors.initials: ML
authors.lastname: Jacobs
authors.forename: Constantine
authors.initials: C
authors.lastname: Mavroudis
authors.forename: Paul Jubeong
authors.initials: PJ
authors.lastname: Chai
authors.forename: Christo I
authors.initials: CI
authors.lastname: Tchervenkov
authors.forename: Francois G
authors.initials: FG
authors.lastname: Lacour-Gayet
authors.forename: Hal
authors.initials: H
authors.lastname: Walters
authors.forename: James Anthony
authors.initials: JA
authors.lastname: Quintessenza
keywords: atrioventricular canal defect; atrioventricular septal defect; cardiac surgery; congenital heart disease; database; endocardial cushion defect; outcomes; results of treatment